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Sunday, October 24, 2010

Looking for My Lady


YOUR CHALLENGE is to write max 500 word piece or a poem about any character who loses an item that when found by another results in their mutual happiness/relief/salvation.
...And here is my entry:



“Where’s my lady?” 

“What do you mean, Elaine? What lady?” 

“My lady! You know.” 

Elaine showed her frustration as the nurse tried to help her. 

Elaine was one of the new residents in the nursing home.  She had suffered a stroke.  Communicating with her was very difficult at times. Typical of a person with expressive aphasia, she couldn’t come up with the right words, even though she knew what she wanted to say in her mind. 

“We need your help,”  the nurse said as she came into my office.  “We can’t figure out what Elaine wants, and we are afraid she is going to get agitated.” 

We rushed to her room.  
  
“Where’s my lady?” she insisted.  

Elaine had no family.  A friend was her caregiver. 

“Are you looking for your friend, Pam?” 

“No. No. ‘My lady’.” 

I wondered if she was referring to a loved one’s picture. I searched through her dresser drawers, finding a picture of Pam. 

“Is this ‘your lady’”? 

“No. No.”  Elaine seemed even more frustrated.  

Is she looking for a doll, a stuffed animal perhaps? I pondered. 
  
“No. No,” she repeated, as I showed her a teddy bear I found on top of her cabinet.

I was growing frustrated myself. This was becoming my most challenging communication task. With an Alzheimer’s resident, I could have easily changed the subject, and he/she would have forgotten all about ”my lady,” or whatever he/she was looking for.  But this case was different. Elaine wouldn’t easily forget what she was looking for.  

Our unsuccessful search for “my lady” went for almost an hour.  Fortunately it was time for lunch.  

“Elaine, it’s time for lunch. I will help you to continue looking for “your lady” after you finish lunch. Is that alright?” 

Eventually, she agreed. I decided to continue my ‘Sherlock Holmes’ search for clues, although deduction doesn’t help much when trying to decode what a person with dementia is really trying to ask for or say.  

I called Elaine’s friend, Pam. I told her what was going on. After a long discussion over the phone, Pam wasn’t much help either. 

I returned to Elaine’s room.  I was positive that Elaine was not looking for a person. She wasn’t asking about a pet either.  Pam had said she didn’t have one. 
I looked throughout her room again.  

The closet!  I had forgotten to look into her closet. What if she was referring to a piece of clothing, or a pair of shoes? I wondered.  

When Elaine was back to her room, I started showing her item after item of things I found in her closet.  It was becoming exhausting as Elaine’s wardrobe was quite large. On the very top shelf of her closet, I spied a black and white handbag. I grabbed it and showed it to Elaine. 

“Yes, ‘my lady’!”  she exclaimed, with a gleeful expression and a big smile.  

I smiled too.  And sighed. 

I left Elaine’s room, hoping that my lunch was still warm.


Thursday, October 21, 2010

Oops!




“I don’t know how you can handle working in a nursing home,” my friend, Daisy, commented, as we shared conversation over a cup of coffee.
“Life in the nursing home isn’t what everyone believes, a place full of just problems and sadness.  Sure we have our share of that.  But it’s also a place where friends and family share memories and vivid experiences.” 
“But don’t you go home loaded down with your resident’s problems?”  Daisy asked, doubtfully.
“Not really,” I replied.  “Sometimes I do get stressed, but for the most part, I feel I can handle the challenges.  You don’t know of all the fun times we have at the nursing home.  It’s a place for conversations, reading, gossip, romance and glamour.  Life there is rich, dynamic and synergistic.”
“Ha! Then why is it called a ‘rest home’ if there’s no rest after all?”
“They’re no longer called ‘rest homes.’ Nursing homes are no longer institutions where people go to die.  They are ‘homes’ where people can continue their lives with the help they need.  And for those that are at the end of life, it’s a place where they can die in comfort with dignity.”
“Wow, so things have changed a lot.”
“I noticed huge changes in the last five years.  Changes in concepts, focus, care, and regulations.  It’s quite interesting.”
“Well, since you find so much fun at the nursing home, do you have any funny story you can tell me?”  Daisy asked, grinning. 
“Oh Lord, I have many humorous stories.  One that makes me laugh every time I recall it, had to do with a resident’s daughter.”
I told Daisy a story that actually became one of my most embarrassing moments at the nursing home.  It was about Cheryl.  Her mother had recently been admitted to the facility.  Since the moment I met Cheryl, I noticed she spoke with a slight foreign accent. 
Her mother was born in Missouri, and she indicated that had lived in that state all her life. I wondered why her daughter had an accent.  Had Cheryl lived outside of the USA? She had a husband, but he was also a Missourian. 
I was so curious.
We had our first care plan meeting.  I would get distracted every time Cheryl spoke because of her slight accent.  The other members of the team didn’t seem to notice it, and no one mentioned anything after the meeting. 
The times I talked to her, I continued to wonder about her accent.  A month later, we had another meeting.  By then, I had established a good relationship her.  After the meeting, I approached Cheryl in the hall, making sure no one was around. 
My curiosity couldn’t wait any longer.  

“Cheryl, I want to ask you a personal question. You have a slight accent.  Have you lived overseas?”
Cheryl stared at me. Then she started laughing out loud. 
I was puzzled.
“No, it’s not an accent,” she said, still laughing. 
 “It’s speech impediment” 

Wednesday, October 13, 2010

And she prayed




May I come in, Ms. Lewis? I asked, after knocking on the resident’s room door. 

“Please, come on in” she answered cheerfully. 

Ms. Lewis was making her bed.  Although she was advised not to walk in her room by herself, she was ambulating around the bed, straightening out a beautiful bed quilt. 

“My daughter made this comforter,” she told me with pride. 

“I see you like to make your own bed.  But remember, the girls can help you,”  I reminded her.  I was concerned about her risk of falling.  Ms. Lewis had sustained several falls at home, and a couple at the nursing home, since her recent admission.  

“I know.  I had a fall today.  I won’t get to go back home. It’s all my fault,” she replied, in sad tone of voice.  
“Ms. Lewis, it’s not your fault.  I know you are feeling stronger and you prefer to do things by yourself.” 
Ms. Lewis lived with her daughter.  While her daughter was at work, Ms. Lewis remained in the home by herself.  For a couple of years this routine worked out quite well. But the arrangement became complicated when Ms. Lewis started showing forgetfulness and confusion, and more so when she had falls which resulted in her hospitalization.  

Going back home was not an option for her.  Ms. Lewis’ daughter and other family members had discussed the subject at length and come to the conclusion that, although Ms. Lewis came to the facility initially for rehabilitation services, the family had already planned for her to stay on long-term care. 

Ms. Lewis had showed great motivation in therapy. She talked constantly about wanting to go back home. But she still faced health challenges, and her acuity was not improving. During her stay, she had been diagnosed with Alzheimer’s dementia.  

Tears began rolling down her face.  I drew closer to her, and as I hugged her, I saw some Guideposts magazines and a Bible on her bedside table. 

“I see you like to read inspirational stories, Ms. Lewis.” 

“Yes, I do.  I also read the Bible, and I pray God every day.  I pray that I can go back home.” 

I looked back at Ms. Lewis with compassion.  It broke my heart to see her pretty eyes turn teary again.  Knowing that her going back home was not an option pained me even more.  

But who am I to have doubtful thoughts?  I criticized myself.  

I immediately realized that Ms. Lewis’ predicament was actually teaching me a lesson of faith.  

“You are working hard in therapy, Ms. Lewis.  Keep your motivation.  And don’t give up on your faith.”  It was strange but I truly didn’t think of the words I said to Ms. Lewis.  It was as though my words just came from my heart.  Ms. Lewis smiled.  

Several weeks later, Ms. Lewis’ daughter came to my office, quite anxious.  

“I know my mother is almost finished with her therapy.  We don’t think she can go home, but she thinks she can.” 

I called for a meeting with the Interdisciplinary team.  We met with the daughter and other family members.  Ms. Lewis was invited as well. 

I noticed Ms. Lewis was quiet.  She sat on the back of the room.  

I am sure she is praying, I thought. 

The meeting started with some turmoil when family brought up safety issues if Ms. Lewis were to go back home, staying alone during the day while her daughter was at work.  I glanced at Ms. Lewis.  She remained quiet, and calm. 

The therapists explained that Ms. Lewis had actually shown remarkable physical improvement.  As the meeting progressed, it began to turn into one of the most amazing meetings I had had with a family.  The therapists explained that her dementia was not going to go away, but if she had someone with her at all times providing supervision for her safety, she could definitely go home. 

Unexpectedly, her granddaughter stood and said: “Grandma, I'm going to quit my job to help you at home.” 

We sat in silence for a few seconds.  Everyone was astonished.  Then smiles blossomed on everyone’s faces.  Especially Ms. Lewis’ face.  She lit up with an expression of hope restored. 

The logistics for Ms. Lewis’ discharge were discussed, and a tentative date for her to go home was scheduled right away.  Her guilt-ridden family members showed signs of evident relief.  Soon, the meeting joyfully adjourned.  

As we were leaving the room, Ms. Lewis, walking with the assistance of a walker, managed to get close to me.  She looked at me, and smiled.  I smiled back.  

“Your prayers were answered, Ms. Lewis,” I whispered to her. 

“Yes. They were.” 

Tuesday, October 5, 2010

Can't let the music stop




“What are you listening to?” my co-worker, Jane, asked, as she walked into my office. 

“It’s Andrea Bocelli,” I replied.  “I work better with music in the background.”  

“Music has magic.  Have you noticed how much the residents enjoy the music in the dining room?” 

“Music can be very powerful.”  I said, sighing.  Talking about music brought special memories to my mind of a few nursing home residents. 

Dorothy was one of those special memories.  She was a sweet lady, but rather quiet.  She normally immersed herself in observing what was going on around her, but wouldn’t say much.  Her main interest was being outdoor, on the gazebo, looking at the Ozark’s hills.  In the winter, she changed her preferred view to the lake.  Winter was the only time of the year when the lake was visible from the facility which sat perched on the top of the hill. 

During my visits with Dorothy she had few answers to my questions.  She was a lady of few words.  Although Dorothy had early stages of dementia, I felt her silence was more her own choice of keeping to herself rather than a cognitive deficit.  A way to preserve her secrets.  She and her late husband had a private life.  With no children or close family, they were known for keeping a quiet and peaceful home.  Dorothy kept that peace in her solitude.  

One weekend I was assigned to coordinate an activity for the residents.  I decided to take some of the residents to the patio and have a music activity playing Nat King Cole songs.  It was a beautiful morning.  The weather was comfortable.  The residents enjoyed snacks and conversation as the music started to play.  With some encouragement, Dorothy attended the group activity, probably because it was held outside.  

Although everyone seemed to be enjoying the music, Dorothy’s eyes suddenly sparkled and a big smile blossomed on her face like never before.  

I drew close to Dorothy, amazed at her transformation. 

“Dorothy, do you like that song?” I softly asked her. 
“Yes, it reminds me of my boyfriend” Dorothy said. “We were in high school” 

Is this the Dorothy I know? I pondered.  My jaw dropped, and I smiled with excitement as I was anxious to hear more.  

When Dorothy spoke, she opened her heart.  She told me about her high school sweetheart, their walks, dances, and holding hands.  That was the longest and most delightful conversation that I have had with Dorothy in her two years as a resident of the facility.  I spent about fifteen minutes listening to her captivating and charming memories. 

My heart pounded as I listened to Dorothy recount her memories. What an honor it was to listen to her lovely recollections. Fond memories which were ignited by the music of Nat King Cole. 

I looked at Dorothy’s beautiful smile again.  

And I wished the music would never stop.   




"...Trying to reach out to you,
Touch my hand,
Reach out as far as you can,
Only me, only you, and the band,
Trying to reach out to you,
Touch my hand,

Can't let the music stop,
Can't let this feeling end,
Cause if I do it'll all be over,
I'll never see you again..."